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Organization
ROBERTO MAURO LOPEZ MD PA
Active
Organization
ROBERTO MAURO LOPEZ MD PA
Active
Other names
Las Fuentes Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SRIKANTH NANGAVARAM (CFO)
(956) 215-6010
Entity
Organization
Contact information
Practice address
1400 W GRIFFIN PKWY SUITE 1, MISSION, TX 78572
(956) 563-7046
Mailing address
2509 SANDSTONE DR, MISSION, TX 78574-2774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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